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28 November 2006

CHIEF EXECUTIVE’S BRIEFING Tom Taylor Chief Executive . 28 November 2006. 2006/ 07 Position . Achieving most targets but not MRSA and Finance Healthcare Commission ratings Quality of Services – good Use of resources - weak. Healthcare Commission Ratings . UHBFT SaTH

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28 November 2006

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  1. CHIEF EXECUTIVE’S BRIEFING Tom TaylorChief Executive 28 November 2006

  2. 2006/ 07 Position • Achieving most targets but not MRSA and Finance • Healthcare Commission ratings Quality of Services – good Use of resources - weak

  3. Healthcare Commission Ratings UHBFT SaTH Core Standards Fully Met Fully Met National Targets Fully Met Fully Met New National Standards Good Good - Fair - Fair - Fair - Fair - Good - Excellent

  4. MRSA • Staff testing policy to be agreed today • Isolation ward at both sites being identified • DoH MRSA team invited to review our procedures • Serious Untoward Incident and Root Cause Analysis required by SHA for every bacteraemia

  5. Financial Position • Month 7 = £2.268 million deficit forecast when the effects of additional in-year pressures are accounted for.

  6. Additional in-year pressures(Unidentified (May Board) £2.2 million ) £M PWC 0.360 Doctors Funding 0.692 Procurement 0.500 AfC 0.553 2.105

  7. Financial Savings “forecast v actual” (as at month 7) • See P Spilsbury slide • Note: • The total savings reported to date: £1,268,210 vs. forecasted position: £1,550,529. Financial gap of £282,319. • The operational savings delivered were above plan by £70,000 • The programme savings delivered were below plan by £ 353,008 (70% approx. are procurement savings)

  8. RAG Financial Savings identified at risk (as at 13.11.06) Programme As at 2nd October 06 As at 13th November 06

  9. Staff/ Public/ MPs/ OSC/ LA/ Trade Union objections • PWC Turnaround proposals • Patient car parking charges • Staff car parking charges • Skill mix review • Bed reduction (through efficiency) • Manpower reduction • Overtime restrictions • Non-pay restrictions • Clinical/ managerial restructure • Strategic Service Plan Proposals

  10. “That leaves 60 organisations … that will not remain in their current form, which leads to the issue of how you reconfigure” Andrew Cash Director General – Provider Development Department of Health

  11. Does this County want a Solihull/ Good Hope solution?

  12. Era in rapid growth ends in 2008 3% ?? National Context – a critical year • 2007/8 is a turning point. Why? • 2007/8 Operating Framework • sort the money out • achieve recurrent stability • limited national priorities • devolved central budgets • 2008/9 • free choice • waiting in effect eliminated • full PbR in operation • and…

  13. Financial requirements • All organisations to at minimum break-even with general expectation of surplus • 2006/07 in-year deficits recovered by organisations • All cash support will be interest-bearing via national loans/deposits scheme with SHA as gateway • PCTs to demonstrate the creation of an uncommitted reserve of at least 2% in 2007/2008 plans • PCTs to demonstrate a bottom-line shift in activity from hospital to community and place a value on that

  14. Cost improvement and efficiency • We will expect cost reductions to be a minimum of 3.5% on top of any local issues • Henceforth we will distinguish between Cost reduction plans & Business improvement plans • We will expect further reductions in workforce costs & headcount for all secondary care providers as part of CIPs and as necessary preparation for 2008/09 • We will set up a Regional Clearing House service to support shifts across organisations & 2°→1° care

  15. Other key assumptions • The “full cost recovery” principle will apply to PCT provided services and to be demonstrated in 2008/09 • Much greater scrutiny of prescribing plans - Keele analysis shows potential for major savings on statins and other drugs not being realised • PCTs to adopt 30-day payment limits in all transactions with NHS Trusts – track in FIMs • All capital will be accessed through interest-bearing debt - SHA will publish tests shortly (including ROI criteria)

  16. Payment By Results • Tariff uplift of 2.5% • Emergency threshold of 50% at 2005/06 outturn • PPA 50% → 25% and will be removed in 2008/09 • Capping: existing rules apply but may be local flexibility for biggest impact (7.5% of turnover) • Unbundling: Presumption in favour

  17. Some absolute standards for March 2008 • 5 weeks maximum wait for outpatients • 6 weeks maximum wait for MRI/CT/Other diagnostics • 11 weeks maximum wait for inpatients • 18 weeks RRT: 85% unplanned, 95% planned • GUM: maximum wait of 48 hours for urgent appointment • MRSA: 60% reduction on 2003/04 base or n<12 • 5% reduction in emergency beddays on 2003/4 base

  18. Our Key Test of Local Delivery Plans • Are Boards signed up to plans? • Are plans based in a long-term financial strategy? • Are plans based in a strategic commissioning vision? • Can PCTs set out a public statement of what will be achieved this year? • Do plans address national priority areas and achieve national targets? • Are plans internally consistent (esp. links of activity, workforce, expenditure)? • Are plans shared across a health economy? • Are plans consistent with scale of challenge? • Are plans realistic and deliverable? • Do plans use opportunities provided by System Reforms?

  19. NB: We are four months ahead of last year Outline Timetable

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